Mesenteric-Jejunal Desmoid Tumor. Incidental Finding in a Patient with Acute Appendicitis: Case Report

Desmoid tumors, formerly called aggressive fibromatosis and fibrosarcoma grade 1, are fibrous tumors that occur without predilection for any sex, in the third and fourth decade of life. They mainly occur in extremities and abdominal wall. This case is a 53-year-old female who was diagnosed with an incidental jejunal tumor due to acute appendicitis. The patient was first treated for an attack of acute appendicitis, during the physical examination an epigastric mass became evident. When abdominal CT (computed tomography) scan was performed, the diagnosis of acute appendicitis was confirmed and the presence of a solid tumor was documented, which suggested involvement of the third and fourth portion of the duodenum. Laparoscopic appendectomy was performed without complications. One week later and as an external patient, a new abdominal CT scan was performed, which suggested “GIST” (Gastrointestinal Stromal Tumor). Study protocol was completed, and exploratory laparotomy was performed with tumor and jejunal diverticulum resection. Within the surgical findings, we observed a jejunum-dependent tumor with a diameter of 7 cm that was located 10 cm away from the Treitz angle. A block resection and a primary jejunal-jejunal anastomosis were performed. The patient was discharged on her POD 10 without any surgical complications.